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tv   Senator Cornyn on Republican Affordable Care Act Replacement Bill  CSPAN  July 13, 2017 9:17am-9:34am EDT

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do choose to throw away this piece of legislation because ith doesn't comport with the goals that republicans have long said we're at the heart of their effort to repeal this bill, there is an important bathroom d bipartisan conversation what is working and admitting together there are big things that aren't working and fixing them together. i yield the floor.nt >> police department as we continue to discuss the better care act, which is an alternative bell that we will propose next week and vote on, that takes the disaster known as obamacare which for millions of americans who has led to sky high premium and unaffordable deductibles if they can even find insurance company that will sell them an insurance product, we will propose a better care act as we call it.
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not a perfect care act but a better care act. it would be even better if our democratic colleagues wold join us in working in had this effort.fo but as we've come to find out, they're unwilling to acknowledge failures of obamacare so we're forced to do this without their snaps and it would be better if it were bipartisan if they would work with us but they have made it very clear that they're not interested in changing the broken structure of obamacare. and what i predict is that what they would offer is an insurance company bailout lowing perhaps hundreds of billions of dollars at insurance companies in ordering to sustain a broken obamacare that will never work no matter how much money you throw at it. so people will continue to suffer from the perils of obamacare unless we'll have the courage to step toward and to say we're going to do the verysa
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best we can with the tough hand we've been dealt to help solve. help save the american people who are being hurting right now. and basically there are four i want to stabilize the individual insurance market which is the one that insurance companies are fleeing now because they're bleeding red ink they can't make any money and they tired of losing money so that basically pick up their -- pull their roots and leave town, and leaving customers in the lurch. secondly we want to make sure that we actually lower insurance premiums under the original discussion draft bill that we introduced about a week or so ago the congressional budget office said you will see premiums go down as much as 30% over time. now, i wish i could say we were going to be able to have immediate affect on thoseut premiums, but the truth is, this is much better than our friends across the aisle have offered us
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with the -- offer to basically sustain a broken obamacare system the third thing we want to do is to protect people who might have their health insurance hurt or impeded by preexisting conditions and we want to maintain the current law so people are protected when they leave their work or when they change jobs. and the fourth is qept to put and medicaid is one of the three program and now we spend roughly 400 billion dollars on medicaid in this country. our friends across l aisle don't want to do anything that would keep that from growing higher and higher and higher to the point where basically the system collapses. we believe that that's not the responsible choice so what we propose to suspend 71 billion dollars more on medicaid over the budget window and to work ta
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transition those states that have expanded medicaid and offer their people a better option in the private insurance area. but i want to mention you know i've shared a number of stories frebs small business owner and down in texas who was forced to fire their employee so they could afford to cope doors opene and provide insurance to the remaining people. now, you have to ask, what in the world could lead us it a system with which would discourage people are from hiring more folks and put them in a position to fire them in order to make ends meet but what's the employer mandate did under obamacare if you have more than 50 employees and employer mandate punished unless you make sure that your employees are covered with insurance, and many times, it is unaffordable so had
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the perverse impact of small businesses say well we can't afford to grow the number of people that are working in our business to o shrink it in order to avoid that penalty.in so stories like this remind how important to repole and replace obamacare the status status quo is not working and obamacare gets worse for millions of people in the individual market in particular. but it is important that obamacare is not just about insurance. obamacare is about penalties that are being imposed on businesses that hurt their able to grow and create jobs. that's one reason i believe that since the great recession of 2008 were ordinarily you would see a sharp bounce up in the economy that the economy has been largely flat and has not been growing in part because the penalty and mandates and thehe regulations associated with obamacare. more
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not only has it made obamacare more expensive taking away choices but compounded problems with safety net programs like medicaid. i want to share a story from an emergency room employee at lake grangd bury texas and alarmed me because fewer and fewer physicians will see a medicaidt, patient, she seen influx of these medicaid patients who have coverage coming to the emergency room. or their primary care, as she points out this is not a good situation for patients and hospitals. and my state, according to latest survey at the texas medical association i've seen only 31% of doctors in texas will see a new medicaid patient that may sound crazy but let me explain why because medicaid
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basically pays physician about half of what private insurance pays when it comes to see a patient many of them simply say well i can't afford to see a lot of medicaid patients so i need to balance that or at least make sure i see enough private insurance patients to make sure i can keep doors open and meet my --e my obligations. but what happens when fewer and fewer doctors actually see medicaid patients is that peopln show up in the emergency room for their primary care because they can't find a doctor to see them and truth is that medical outcomes based on many of studies that have been done in recent years are -- that medicaid coverage in those instances can be no worse and no better than having not having insurance at all. obamacare was put in place to avoid reliance on emergency room for access to care.ca but as we all know obamacare hasn't lived up to many of its promises.
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and unfortunately making stories like this one common place. i mentioned this earlier but in just to see the trendline in 2 thowrkz 6,000 received new head. keyed patients today that number is is 34%. it is actually 34% due to low rates of provider reimbursement leave patients in places like grangd bury in lurch and causing had them to turn to emergency room for their primary care as last resort. t every two years they fighth request texas legislature to raise payments for the medicaid system but the reality is, there's not enough money to go around. even though it is the number one or number two budget item in the texas legislature budget every year. and it is growing so past it is crowding out everything from higher education to law enforcement and other priorities. across the country medicaid spending has ballooned out of
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control. in texas 25% of the states budget as i deathed dedicated to this program. 25% of its overall budget usually number one or two, so we have to be honest with ourselves in the people we represent that this situation is not sustainable. and we owe to it people to make sure people who really need it, the fragile elderly, disabled, adults and children that it is there for them. not only now but in the future. that's why we've been discussing ways we might strengthen the sustainability of medicaid and ensure that family who is actually immediate it can rely on it.ve and they don't have the rug pulled out from under them but this requires doing some hard work.rd of reforming the way that states handle medicaid funding. for example, medicaid is current is currently applied states are only allowed to review their list of medicaid recipients once
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a year. but a lot can happen in period of a year somebody can get a job. they may no longer be eligible based on the income qualifications for medicaid. but if you can only check once a year, then people remain on role even though they no longer qualify so regardless of whether somebody gets a job or moves -- or passes away or no longer needs medicaid they're still in the system and there's nothing states can do about it. well, we would like to change that. while it sound like a simple matter when the average medicaid patient coast the state more than $9,000 each and high as almost 12,000 per elderly individuals it adds up. now one of the things we saw that obamacare did in the states that expanded medicaid coverage is that those states decided to cover single adults who are capable of working.
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well, what this bill would also do is what would be allowed the states to experiment with a work requirement as part of the eligibility for medicaid we're not mandating it. you have to do it. but if state chooses to do it then they could do so. so we need to give the states the flexibility they need so they can use the medicaid funding that they have more efficiently and so more people can get access to quality care. i want to be clear, 4.7 million texans rely on medicaid. of course, those roles tend to churn based on peoples' employment and family circumstance but it is not going anywhere. we want to make sure we preserve medicaid for the people who actually need it the most and working to make it stronger. more efficient, and yes, more sustainable.us you know, i guess some people live in a fantasy world where they think we can continue to spend money we don't have and
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there will never be any consequences associatessed with it. well the fastest items of spending on federal budget or entitlement program including medicaid right now are we're at about $20 trillion. we've done a pretty good job id know we don't get much credits are for it pretty good job of controlling discretionary spending 30% of federal spending we actually appropriate but the 70% of mandatory spending including medicaid have been going up on average about 5.5% a year. quell that can't happen ingh perpetuity right now we know we have 20 trillion dollars roughly in debt. 20 trillion dollars it's frankly immoral for those ofs who are adults today to spend money, borrowed from our next generation and beyond because somebody ultimately is going to have to pay it back and it is going to have real world oonsequences. we know since the great recession that federal reserve is kept interest rates very lowr
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through the monetary policy, but we know as well that as the economy tends to get a little bit better on unemployment come down they're going to be inching those interest rates up littlele by little which means we're going to end up paying the people that owe -- own our debt our bondholders more and more money strictly for the purpose of giving them a return on their investment for the debt that they buy. so this is an opportunity for us not only to put medicaid on a sustainable path to do the responsible thing. to give the states ultimate flexibility in terms of how they handle it, it's also a matter of keeping faith with the next generation and beyond when it comes to this unsustainable deba burden. ... hear people talk about slashing medicaid despite the fact that the congressional budget office estimates that medicaid spending will grow by
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$71 billion over the next ten years. only in washington, d.c., is that considered a cut where spending next year exceeds what it is this year and the next year and so on, it goes up $71 billion. you will hear people come to the senate floor and say that that's a cut, we're slashing medicaid. it's nothing of the kind. well, to me, the choice is clear. clear. the choice is clear. we want to continue with the failures of obamacare or do we want to do our very best to try to provide a better choices and better options? do we want to continue to allow the status quo which is hurting families, putting a strain on doctors and our emergency rooms and hospitals like i mentioned? what we want to address the s fundamental flaws of our healthcare system? i wish we could do something perfect but certainly with ther
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constraints imposed by the fact our democratic friends are not willing to lift a finger to help and given the fact we have to do this using the budget process, those are some pretty serious constraints. we basically have to do this with one arm tied behind our back. but we're going to the best we can because we owe it to the people we represent. i would encourage our colleagues on both sides of the alta try to take a fresh look at this and figure out how can we be part of the solution not just to compound the problem. there is one thing that i haven't mentioned that i'm particularly excited about in the better care act, and that is for states like texas that did not expand medicaid to cover able-bodied adults in the hundred-138% of federal poverty level. what we have done and a care act is provide them access to private health insurance and coverage for the first time.
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it's about 600,000 texans, low income texans who for the first time under the provisions of this bill will access to a tax credit, and states using the innovation and stability fund, and something called section 1332 waivers will be able to design programs which will make healthcare more affordable in the private insurance market. one reason people prefer the private insurance market to medicate is for the reason i mentioned earlier. that medicaid -- >> this morning we will continue our overse oversight efforts wih regard to the 2017 trafficking in persons report. want to thank senator cardin and members of the committee for their leadership and engagement in combating this affront to human dignity and the rule of law. this committee is conducted extensive oversight on this issue frequent instituted annual briefings from members of the committee with the office of traffickin

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